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CC_Minutes_2013_1118
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CC_Minutes_2013_1118
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12/17/2013 9:45:31 AM
Creation date
11/26/2013 11:00:14 AM
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Roseville City Council
Document Type
Council Minutes
Meeting Date
11/18/2013
Meeting Type
Regular
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Page 6 PLEASE TYPE OR PRINT ALL INFORMATION <br /> STATE ASSIGNED LICENSE NUMBER 0252 _ 44 _ 005 _003 <br /> ALL APPLICANTS ANSWER THE FOLLOWING <br /> 6.1 HAS THE APPLICANT EVER BEEN DENIED A LIQUOR LICENSE IN NEW JERSEY? Yes XX No <br /> IF THE ANSWER TO THIS QUESTION IS"YES,"ANSWER THE FOLOWING: <br /> Type of License or Permit Denied: Retail Wholesale Transportation <br /> Warehouse Manufacturer <br /> Unit of Government which denied License or Permit: <br /> Date of Denial(approximate if not known) / / <br /> Reason for Denial <br /> 6.2 HAS ANY CORPORATION,PARTNERSHIP OR INDIVIDUAL MENTIONED IN THIS APPLICATION,OTHER THAN THE <br /> APPLICANT, BEEN DENIED A LIQUOR LICENSE OR PERMIT? Yes XX No <br /> IF THE ANSWER IS"YES,'ANSWER THE FOLLOWING: <br /> Name of Entity <br /> Last Name First Name Middle Initial <br /> Type of License or Permit Denied: Retail Wholesale Transportation <br /> Warehouse Manufacturer <br /> Unit of Government which denied License or Permit: <br /> Date of Denial(approximate if not known) I I <br /> Reason for Denial <br /> 6.3 HAS THE APPLICANT OR ANY OTHER PERSON, CORPORATION OR ENTITY MENTIONED IN THIS LICENSE <br /> APPLICATION, OR ANYONE WITH A BENEFICIAL INTEREST IN IT, HAD AN INTEREST IN A NEW JERSEY <br /> ALCOHOLIC BEVERAGE LICENSE WHICH WAS SURRENDERED,SUSPENDED OR HAD A PENALTY IMPOSED IN <br /> LIEU OF SUSPENSION,NOt. ENEWED,REVOKED OR CANCELLED WITHIN THE 10 YEARS PRIOR TO THE DATE <br /> OF THIS APPLICATION? yes No <br /> IF THE ANSWER IS"YES,"PROVIDE DETAILS OF EACH BELOW[Complete a separate Page 6 for each action]: <br /> Name of Individual Cherry Hill Wine & Spirits Inc. <br /> • Last Name First Name Middle Initial <br /> DATE OF ACTION 01 ,/ 01 / 1997 DOCKET NO. 06028-965 <br /> PENALTY WAS IMPOSED BY: Division of ABC <br /> [Indicate whether by Division of ABC or identify Local Issuing Authority] <br /> PENALTY CONSISTED OF: <br /> XX FINED $ 10,000.00 NOT RENEWED <br /> `amount] <br /> XX SUSPENDED ONE DAY REVOKED CANCELLED <br /> (number of days) <br /> OTHER[explain] <br /> 6.4 HAS THE APPLICANT OR ANY OTHER PERSON OR CORPORATION MENTIONED IN THIS LICENSE APPLICATION, <br /> OR ANYONE WITH A BENEFICIAL INTEREST IN THE BUSINESS UNDER LICENSE OR TO BE LICENSED,EVER BEEN <br /> CONVICTED OF A CRIMINAL OFFENSE? Yes XX No <br /> A. IF THE ANSWER IS"YES,'ANSWER THE FOLLOWING: <br /> Name of Individual <br /> Last Name First Name Middle Initial <br /> Date of Birth / / Conviction Date / / <br /> State _ Court of Jurisdiction <br /> Description of offense(specific charge) <br /> Disposition(fine,penalty,etc.) <br /> Nature of interest in entity to be licensed <br /> B. If applicable,provide the date the Director of the N.J.Division of Alcoholic Beverage Control issued an order approving <br /> or disapproving disqualification removal: / / . (No license may be issued without an order <br /> from the Director of the Division of Alcoholic Beverage Control determining no disqualification or removing <br /> disqualification.) (See R.S.33:1-31.2 and N.J.A.Q.13:2-15.) <br /> Provide Agency Docket No. :[NN]-, <br />
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